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So what's the catch? Do health policy PhDs fare well in the job market compared to pure econ PhDs? Are they restricted in any way?

From job market reports, it seems like the vast majority of pure econ students in top PhD programs (including Harvard Econ, MIT Econ, Stanford Econ, etc) who are interested in health end up in health care policy departments in medical / public health schools anyways. Is the trajectory really that different? If you're into health, why choose pure econ over one of these programs?

Agree with tm_member. I'd long considered an econ PhD but ultimately I chose a health policy PhD program (wrapping up my first year now). I made that decision because: I was 100% certain I wanted to do health policy research, I felt I needed to learn more about the institutions, and I knew I wanted to be more of a consumer than a producer of pure econ research. I think the only similarities between econ and health policy PhD programs is that there can be significant overlap in the training. Most health policy programs require econ-focused students to take micro, econometrics, and a handful of field courses in the econ department.

Otherwise, I think there are many differences. For one, you will likely have a number of courses devoted to understanding the structure of and institutions involved in healthcare payment and delivery. Second, your cohort may consist of many non-econ-focused students, which may make for a different environment. Related and broadly speaking, the field of health policy/health services research is very interdisciplinary so it's not uncommon to work with non economists and to have those folks on your dissertation committee. Third, you'll ultimately be acculturated to a different professional community (though of course there is some overlap). For example, you may or may not go to the AEA conference in January, but may instead find your job by attending the AcademyHealth research meeting or ASHEcon. Some coming from a health policy PhD may consider themselves a health economists, but others will consider themselves a health services researcher. Fourth, there will be pressure to publish during your PhD. Most health policy PhDs on the job market will have at least a handful of pubs and that is certainly expected, while that is typically not the case for econ PhDs. Related, your target journals may not include any of the top econ journals or even JHE, but instead may include Health Services Research, Health Affairs, or even one of the JAMAs. You will likely never publish a solo-authored research article. Finally, I don't know that the admissions are more lenient per se, but they are different. These are typically small programs who admit a handful of students in a given year, and that translates to an admissions rate of roughly 5-12%. The expectation is not necessarily that you'll have advanced math coursework (e.g. real analysis), but many applicants do so you may be at a disadvantage if you do not. The GRE expectations at the top health policy programs will be roughly the same. Basically, many applicants look like econ PhD applicants, except health policy PhD programs rarely take folks straight from undergrad. So they tend to have a similar transcript to those applying for econ PhDs, plus they have at least a few years of work experience and/or a masters degree. And work experience is tremendously important for admissions. Check out profiles of the students at Harvard and Penn, for example.

I checked out the profiles of some job market candidates and current PhD students at Harvard/UPenn/Stanford/Yale in Health Policy Econ program. Suffice it to say, they would have got in any TOP 20-30 Pure Econ programs anyway. They are all Econ/Applied Math/Statistics majors. I suspect that you are right on how these programs tend to be slightly more lenient in terms of admission. But, I'd still caution it because everyone who will end up getting in is the TOP NOTCH applicant.